Abstract:

A considerable body of research has accumulated regarding aggression toward health care staff, yet
little is known about the contextual factors involved. The present study examined the context within
which aggressive incidents occurred and the dynamics of the interaction between staff and patients.
Two aspects in particular were investigated; firstly, whether incidents were preceded by some anxiety
provoking stimulus and secondly, the assailants’ levels of cognitive processing apparent at the time of
the incident. A prospective study collected data concerning incidents of physical assault and threatening
behaviour in a general hospital. Staff were interviewed soon after the incident occurred. A content
analysis determined that 82.8% of incidents involved experiences delivered by the staff victims likely to
have provoked anxiety in the assailant. Most commonly, incidents involved staff intervening in the
patient’s intended behaviour. In addition, in 64% of cases, assailants were actually displaying some
impairment in cognitive processing at the time of the incident Data suggest that many patients may not
have been fully aware of their situation and might have experienced some difficulty in comprehending
the staff member’s actions. Patients who do not appear to understand what is happening may require
additional time and effort to ensure they comprehend fully and accept what the staff member is
intending to do, particularly if patients are experiencing an event likely to increase anxiety levels.